Symptom-Triggered Brief Alcohol Withdrawal Scale Inpatient AWS Protocol

Alcohol withdrawal syndrome is unpredictable so managing AWS with scheduled meds invariably leads to under or over-treatment.  CIWA-Ar is the best known severity scale but is lengthy and sometimes challenging to use so many alternatives have been developed. It probably doesn’t matter which scale is used–the benefit of symptom-based treatment over scheduled treatment arises not from the scoring tool but from the frequent reassessments.

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BAWS on mdcalc

Treatment of Wernicke's encephalopathy

For patients for whom there is low suspicion of disease or for those simply requiring prophylaxis, a minimum of 100 mg should be
administered intravenously. For those with confirmed or highly suspected disease and for those who have "failed" the 100-mg
regimen (eg, persistent mental status changes or ocular palsy), we recommend a dosage upwards of 500 mg intravenously.
Ann Emerg Med. 2007;50:715-721.

PulmCrit Alcohol withdrawal protocol / Outpatient Alcohol Detox (Librium Chlordiazepoxide) / Dryden Non-Agonist Outpatient Opiate Withdrawal Meds

 

 

Outpatient alcohol withdrawal management, per ARCA protocol.

Naltrexone 50 mg tabs: half tab on first day then 1 tab daily after eating, Disp x 30

CDZ 25 mg tabs:  1 tab q6h x 2 days, then 1 tab q8h x 2 days, then 1 tab q12h x 2 days, then 1 tab daily x 2 days. Dispense x20.

Folic Acid (B9) 1 mg tabs: 1 tab daily, Disp x 14

Thiamine (B1) 100 mg tabs: 1 tab daily, Disp x 14

Carbamazepine 200 mg tabs: 1 tab q12h, Disp x 14 (7 days)

 

from Asplund 2004

Dryden Outpatient Opiate Withdrawal Rx 2011

Discharging Inebriates